“Publish or Perish” – sparks an unintentional arms race?

When I was applying to residency, a surgeon describing his program once said to me,

“One of our residents graduated with more than 100 publications! If you come here, we can make you that superstar.”

Wow, more than 100 – my jaw dropped.

Then as the year went on, it kept happening. When introducing the grand rounds speaker or the society president, academic surgeons or clinicians would say: “This surgeon has over 300 peer-reviewed publications.”

Sometimes the number was frankly unbelievable.

“Over the course of their career, this surgeon has published over 800 papers in addition to co-writing 50 textbook chapters.”

As an impressionable student, I came to believe the “# of publications” was the most important way to get ahead and open doors. It was clear to me that the people who rose to positions of academic leadership, both at the level of the institution as well as national societies, were all publishing constantly.

But after participating in this trend feverishly for nearly a decade, I now feel this perception is toxic, especially for students and trainees.

It turns out, perhaps intuitively, the number of publications does not encapsulate whether you’re a good provider, resident, teacher, teammate, or partner. It’s just one metric, and a crude one. It does not measure quality, impact, or the number of hours you spend helping others.

What it has done, instead, is start some very alarming data trends in the world of medical education. In 2011, students who matched in dermatology and plastic surgery had 7.5 and 8.1 academic items. By 2020, in just one decade, those numbers were 19.0 and 19.1, respectively.

In 2011, 17.2% and 12.2% of the applicants matching in dermatology and plastic surgery had a Ph.D. or other graduate degrees. By 2020, 29.9% and 24.2% of them did, respectively.

In its extreme, the pressure to publish has led to people simply replicating studies, prioritizing easy, low-impact work, falsifying their academic records, and exploitation of labor from people in positions of powerlessness. Many people are leaving academia. Authors are literally paying money, instead of being paid, to publish their hard work. We have created an arms race in academia.

The new application cycle is coming up.

Can we please stop this harmful race, and stop glorifying this metric?

_____________________________________________________________________________________________________________________________________________________

Jason J. Han (@JasonHanMD) is a cardiac surgery resident in Philadelphia and is part of the TMS leadership.

Want to read more articles like this? Sign up for the TMS newsletter to be notified of our latest content, including videos!

The opinions expressed in the article is not affiliated with any institution, company or product. The article should not be interpreted as medical advice.